Malpractice costs have docs seeking shelter elsewhere

By Alison Snyder
http://www.libn.com

The high cost of medical malpractice insurance has some obstetrician/gynecologists cutting back on the scope of their business, while others are fleeing New York altogether.

And Long Island hospitals are worried that the price of malpractice insurance will lead to a health-care access crisis for pregnant women and for lower-income patients.

Donn Haber, vice president for risk management at the North Shore-Long Island Jewish Health System, said all hospitals, including those in his network, are affected by doctors moving out of state, dropping hours or slicing back parts of their practice.

Already arguing they’re choked by high insurance costs, doctors were drilled again last July, when, with the approval of State Insurance Superintendent Eric Dinallo, New York upped medical malpractice insurance by 14 percent. In 2007, ob/gyns paid the fourth-highest amount for medical malpractice insurance in the nation, according to the Medical Liability Monitor. Suffolk and Nassau ob/gyns that participate in the Medical Liability Mutual Insurance Co. pay a starting rate of $177,880. About 60 percent of ob/gyns here are part of Medical Liability Mutual.

And it could get more expensive.

Dinallo recently put together the Medical Malpractice Liability task force to address the mounting insurance costs – and the group is slated to make recommendations in the coming months. Though further details are sketchy, many doctors aren’t expecting much relief.

Martin Matalon, an ob/gyn practicing in Bay Shore, decided to cut back on his practice after the 2007 rate increase. He no longer performs major surgeries and doesn’t see patients past a certain stage in their pregnancies in an effort to curb malpractice insurance costs. He said he’s not alone.

Matalon conducted his own survey of private ob/gyns affiliated with Southside Hospital in Bay Shore and Good Samaritan Hospital in West Islip and he said he found four physicians had moved off Long Island, one had retired, and nine ob/gyns either had discontinued or had cut back on practicing obstetrics. Fifteen physicians had taken a position in a clinic to supplement their private-practice income. The reason? To help pay for malpractice insurance.

Salvatore Leo, division director of obstetrics at Good Samaritan, said we’re only seeing the “tip of the iceberg.�

A survey sponsored by the Medical Society of the State of New York conducted after the rate increase indicated that 50 percent of physicians said they were seriously considering leaving the state to practice elsewhere. Fifty percent said they had trouble paying for medical malpractice insurance and 21 percent said more than 30 percent of their overhead went toward paying it.

While Matalon said physicians will wait to act until the Medical Malpractice Liability task force gives its recommendations, Matalon said he doesn’t “expect anything much to come out of it.�

Matalon is taking a wait-and-see approach, but he realizes another increase is possible. And if the increase is in the double digits, the physician of 35 years said he would drop obstetrics altogether.

That’s one reason why State Sen. Kemp Hannon, R-Garden City, the chair of the senate Standing Committee on Health, said he is fighting for health-care reform that includes relief for overburdened doctors. But he is concerned many doctors have given up on the system and will cut back – or go away – without a fight.

“I’m scared that we’re just going to have people simply stop practicing,� he said. “It has been noticeable that the physician community has been quiet – it hasn’t spoken up, and I tend to think there’s too many people planning, saying ‘you know, four more years and my kids are out of high school, and I’m going to move.’�

But Joseph Awad, immediate past president of the New York State Trial Lawyers Association and head of its medical malpractice committee, said doctors have no one to blame but themselves for their predicament.

Awad said high malpractice insurance rates are caused by a refusal of doctors to police themselves – and allowing a select few to raise rates for the rest.

He argues there are more obstetricians per capita on Long Island than there were five or 10 years ago.

“We have no tolerance for those scare tactics,� he said, adding the data disproves it. Awad’s protests aside, the medical community’s prepared to pack its bags.

And as J. Gerald Quirk, chair of the department of obstetrics and gynecology at Stony Brook Medical Center, points out, the biggest losers in this will be patients – especially “the medically underserved.�
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